Nonstress tests

Archived User

Nonstress tests

November 20, 2008 05:18 PM

My OB told me today that the research shows that patients
diagnosed with GD benefit from stress tests 2 time a week because
it has been shown that if you have a normal stress test your baby's
chance of living thru the next 4 days is 98-99%. Do you
know the research she is citing and do you know of any other that
promote or not the effectiveness of the nonstress tests?

Thank you.

Henci Goer

I don't. Ask your ob for the research, and I will be happy to go
over it for you.

I can say this, though: the problem with all tests of fetal
well-being is their high false-positive rates, that is, the test
says there is a problem, but there really isn't. In a healthy
woman, which you are if your GD is under control--or even in a
woman with moderate problems--the test is much more likely to be
wrong than right if it says there is a problem. But no one is going
to sit on their hands with a test result that says the baby is in
trouble, so women who have tests of fetal well-being are not
infrequently going to end up with labor inductions, cesarean
surgeries, or both that they didn't need. Add on to
that the false-negative rate: the test says everything is fine
when it isn't. It is also possible to have a true positive where
delivering the baby won't solve the problem. In fact, it is also
possible for a compromised baby to be able to tolerate normal labor
but not induced labor where contractions can be longer, stronger,
and closer together. Even a healthy baby can be distressed who
wouldn't have been with natural contractions. (This, of course,
just reinforces the medical model approach. "Thank goodness we
intervened," everyone says, it never occurring to them that
intervening was what caused the baby to go into distress.) In
short, the odds are 99.9% that your baby will live through
the next four days whether you have the stress test or
not, and you could end up with a cesarean that you didn't
really need and, ironically, that puts you, your baby, and
future babies at greater risk of death and serious harm.